These data reflect the most commonly purchased benefits package for each of the health plans in
the year 2000. Coventry/Principal would not supply updated information.
HMO Family Planning

NOTE: This coverage is prior to changes in state law which mandate certain coverage of contraceptive medications and devices.
Aetna US Healthcare Covers: Referral to family planning services, and referral to and payment for services of appropriate agencies as necessary.

Excludes: Norplant and other implanted birth control devices such as IUDs, diaphragms, condoms, and contraception drugs.
Blue Cross Blue Shield Covers: Prescribed contraceptive devices, diaphragms, and oral or injectable contraceptives (e.g. the pill, Depo-Provera). Also covers vasectomies and tubal ligations.

Excludes: Other contraceptives, like Norplant and IUDs, are excluded.
CIGNA / Healthsource Covers: Diaphragms, IUDs, Norplant and Depo-Provera with copayments. Also covers vasectomies and tubal ligations

Limits: Prior authorization for Norplant and Depo-Provera is unnecessary if received from the gynecologist’s office services. Prior authorization is required for tubal ligations and vasectomies.

Cost Sharing: Copayments apply.
Doctors Health Plan Covers: Vasectomies, tubal ligations, diaphragms, IUDs, Norplant, and Depo Provera.

Cost Sharing: Copayments may apply.
Generations Covers:
  • Counseling and education about birth control.
  • Counseling and diagnostic services for genetic problems and birth defects.
  • Tubal ligation and vasectomy procedures.
  • Birth Control pills, IUDs, Norplant and Depo Provera.
Optimum Choice Covers: Examinations, insertion and removal of intrauterine devices (IUDs), Depo Provera, and Norplant, prescriptions for birth control methods, and genetic counseling (when medically necessary). Also covers male or female surgical sterilization.

Cost Sharing: 50% copayment applies for Norplant.

Excludes: Reversal of voluntary sterilization.
PARTNERS Covers: Voluntary sterilization (tubal ligation and vasectomy).

Excludes: Other contraceptive devices/fittings, supplies or treatment including (unless included in a rider) diaphragms, IUDs, Norplant, and Depo Provera unless covered by a prescription drug rider.
Coventry/Principal Health Care of the Carolinas Covers: Family planning counseling, information on birth control, insertion and removal of intrauterine devices, fittings for contraceptive diaphragms, birth control pills and contraceptives prescribed to treat a medical condition. Also covers male or female elective surgical sterilization.

Excludes: Prescription drugs, medicine, supplies, or devices related to birth control. Genetic counseling that is not needed for diagnosis or treatment of genetic abnormalities is also excluded.
QualChoice Covers: Sterilization services for the member and spouse.

With the purchase of a rider, covers: Birth control devices and the insertion or removal of contraceptive devices or drugs, including, but not limited to, Norplant, Intrauterine Devices (IUD), or diaphragms.

Excludes: The reversal of voluntary sterilization, and sterilization for dependents.
United HealthCare Covers: Surgical insertion or removal of birth control implants under the skin performed in a participating physician’s office. Specifically covers:
  • Physical exams, related laboratory tests and medical supervision provided by PCP.
  • Information and counseling on contraception, including prescribing a contraceptive.
  • Insertion and removal or an intrauterine device (IUD) or a birth control device implanted under the skin, such as Norplant.
  • Fitting a diaphragm
  • Vasectomy.
  • Elective tubal ligation.

Limits: Limited to one insertion or removal per 4-year period.

Cost Sharing: Copayment applies.
The Wellness Plan of North Carolina, Inc. Covers: Counseling, tubal ligation, vasectomy, diaphragms, IUDs, Norplant, and Depo-Provera.

Excludes: Birth control, except for the treatment of a medical condition. Treatment must be prescribed by a physician and approved by TWP-NC.

Note: Birth control pills may be covered under a supplemental policy.
WellPath Covers:
  • Physical exams, related laboratory tests and medical supervision provided by PCP.
  • Information and counseling on contraception, including prescribing a contraceptive.
  • Insertion and removal or an intrauterine device (IUD) or a birth control device implanted under the skin, such as Norplant.
  • Fitting a diaphragm
  • Vasectomy.
  • Elective tubal ligation.

Cost-sharing: Copayment applies.

Excludes: Diaphragm unless covered separately under prescription drug supplemental policy.

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